纹状体内 18F-FDOPA PET 扫描的梯度分析用于鉴别帕金森病。

Intrastriatal gradient analyses of 18F-FDOPA PET scans for differentiation of Parkinsonian disorders.

机构信息

Department of Nuclear Medicine and Molecular Imaging, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9700 RB, Groningen, the Netherlands.

出版信息

Neuroimage Clin. 2020;25:102161. doi: 10.1016/j.nicl.2019.102161. Epub 2020 Jan 3.

DOI:10.1016/j.nicl.2019.102161

PMID:31981888

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6976972/

Abstract

AIM

L -3,4-dihydroxy-6-18F-fluorophenylalanine (18F-DOPA PET may be used to distinguish subjects with Parkinsonism from those with symptoms not originating from impaired dopaminergic transmission. However, it is not routinely utilized to discriminate Idiopathic Parkinson's disease (IPD) from Atypical Parkinsonian Disorders (APD). We investigated the potential of FDOPA PET to discriminate between IPD and APD, with a focus on the anterior-to-posterior decline in het striatum, considered to be more specific for IPD.

MATERIALS AND METHODS

18F-DOPA PET data from a total of 58 subjects were retrospectively analyzed. 28 subjects had idiopathic Parkinson's disease (14 male, 14 female; age at scan 61 +- 11,5), 13 atypical Parkinsonian disease (7 male, 6 females; age at scan: 69,6 +- 6,4) and 17 were controls (6 male, 11 female; age at scan 65,3 +-8,6). Regional striatal-to-occipital ratio's (RSOR's) were calculated, as well as multiple in-line VOI's from the caudate nucleus to the posterior part of the putamen. The linearity of anteroposterior decline was determined by a linear regression fit and associated R squared values. ROC curves were calculated to assess the diagnostic performance of these measurements. Data contralateral to the clinically most affected side were used for analysis.

RESULTS

ROC curve analysis for differentiation between controls and Parkinsonism patients showed the highest AUC for the caudate nucleus-to-posterior putamen ratio (AUC = 0.930; p < 0.00) and for the R squared value for the linear regression fit (AUC = 0.948; p = 0.006). For discrimating IPD from APD, the highest AUC was found for the caudate nucleus-to-anterior putamen ratio (0.824; p < 0.001) CONCLUSIONS: Subregional analysis of the striatum in F-DOPA PET scans may provide additional diagnostic information in patients screened for a presynaptic dopaminergic deficit. A more linear decrease from the head of the caudate nucleus to the posterior putamen was present in patients with IPD, although this feature did not have additional diagnostic value over the RSOR analysis.

摘要

目的

L-3,4-二羟基-6-18F-氟苯丙氨酸（18F-DOPA PET 可能用于区分帕金森病患者和那些多巴胺能传递受损引起的症状不同的患者。然而，它通常不用于区分特发性帕金森病（IPD）和非典型帕金森病（APD）。我们研究了 FDOPA PET 区分 IPD 和 APD 的潜力，重点是纹状体前部到后部的下降，被认为更特异于 IPD。

材料和方法

回顾性分析了总共 58 名受试者的 18F-DOPA PET 数据。28 名受试者患有特发性帕金森病（14 名男性，14 名女性；扫描时年龄 61 +- 11.5），13 名非典型帕金森病（7 名男性，6 名女性；扫描时年龄：69.6 +- 6.4），17 名对照组（6 名男性，11 名女性；扫描时年龄 65.3 +- 8.6）。计算了纹状体到枕部的区域比（RSOR），以及从尾状核到壳核后部的多个线性感兴趣区（VOI）。通过线性回归拟合和相关的 R 平方值确定前后下降的线性。计算 ROC 曲线以评估这些测量的诊断性能。使用对侧于临床最受影响侧的数据进行分析。

结果

ROC 曲线分析用于区分对照组和帕金森病患者，结果显示尾状核到壳核后部的比率（AUC = 0.930；p < 0.00）和线性回归拟合的 R 平方值（AUC = 0.948；p = 0.006）的 AUC 值最高。为了区分 IPD 和 APD，尾状核到壳核前部的比率的 AUC 值最高（0.824；p < 0.001）。